The Controversial Role of Homocysteine in Neurology: From Labs to Clinical Practice
Open accessAbstract
Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy can be caused by deficiency of either vitamin B12 or folate. Hyperhomocysteinemia (HHcy) can be responsible of different systemic and neurological disease. Actually, HHcy has been considered as a risk factor for systemic atherosclerosis and cardiovascular disease (CVD) and HHcy has been reported in many neurologic disorders including cognitive impairment and stroke, independent of long-recognized factors such as hyperlipidemia, hypertension, diabetes mellitus, and smoking. HHcy is typically defined as levels >15 micromol/L. Treatment of hyperhomocysteinemia with folic acid and B vitamins seems to be effective in the prevention of the development of atherosclerosis, CVD, and strokes. However, data from literature show controversial results regarding the significance of homocysteine as a risk factor for CVD and stroke and whether patients should be routinely screened for homocysteine. HHcy-induced oxidative stress, endothelial dysfunction, inflammation, smooth muscle cell proliferation, and endoplasmic reticulum (ER) stress have been considered to play an important role in the pathogenesis of several diseases including atherosclerosis and stroke. The aim of our research is to review the possible role of HHcy in neurodegenerative disease and stroke and to understand its pathogenesis.
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Accumulated homocysteine is a suspected risk factor for cognitive dysfunction and dementia, although this point remains controversial.
“which is a suspected risk factor for cognitive dysfunction and dementia, although this point remains controversial [94,171,172].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [172]
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- Authors
- Moretti, R., & Caruso, P.
- Affiliations
- University of Trieste (IT)
- Corresponding author
- Moretti, Rita
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2019-01-08
- Volume
- 20
- Issue
- 1
- Pages
- 231
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC6337226
- OpenAlex
- W2909201298
- Cited by
- 248
- References
- 199
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 29 · 2023: 42 · 2022: 47 · 2021: 31 · 2020: 41 · 2019: 16 · 2018: 1
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Physiology › Biochemical effects in animals
- Keywords
- homocysteine, hyperhomocysteinemia, stroke, neurodegenerative diseases, cardiovascular disease, atherosclerosis, oxidative stress, endothelial dysfunction, endoplasmic reticulum stress, inflammation, folic acid supplementation, vitamin B12 deficiency, folate deficiency, cognitive impairment
- MeSH terms
- Animals, Homocysteine, Humans, Inflammation, Neurology, Practice Patterns, Physicians', Vitamin B 12, Reactive Oxygen Species
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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